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血性腹膜透析液(腹腔积血)

Authors
Anthony Bleyer, MD, MS
John M Burkart, MD
Section Editor
Thomas A Golper, MD
Deputy Editor
Alice M Sheridan, MD
Translators
甘红兵, 副主任医师

引言

腹膜透析患者出现血性腹膜透析液(腹腔积血)的情况并不多见。本文将总结该问题的原因、诊断和治疗。透析患者的其他腹部疾患，包括需要即刻外科治疗的异常情况，将单独讨论。 (参见“透析患者的胃肠道疾病”)

病因及流行病学

腹腔积血的发生率从总体的6%至绝经前女性的高达57%不等[1,2]。血性腹膜透析液可能与腹膜透析导管、腹膜透析操作、基础肾病(例如多囊性肾病或获得性囊性肾病)有关，或者可能由一些与肾脏疾病无关的因素所致。进行腹膜透析液体交换可以早期检测到腹腔内出血，包括那些不进行腹膜透析的话该症状就不会临床显现的良性病例。

一项纳入424例患者的单中心病例系列研究总结了腹腔积血的原因，其中26例患者(6%)出现1次或多次腹腔积血[1]。据出血的严重程度和原因，可将患者分成不同的组：

●在病例最多的一组(n=21)，出血为轻度、无症状的，透析液变为浅粉色或红色。仅给予这些患者保守治疗，未广泛评估。研究者认为7例患者的出血是由于月经，4例患者是由于出血素质(使用华法林或血小板减少)。

●移植肾切除术、体力活动增加、导管重新定位和股动脉血肿造成腹膜出血各1例。

        

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Literature review current through: 2017-06 . | This topic last updated: 2016-04-08.
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